title: Anisakis allergy component-resolved diagnosis: clinical and immunologic differences between patients from Italy and Spain.
abstract: BACKGROUND
  Anisakissimplex is the main organism responsible for the zoonotic disease anisakiasis which follows the ingestion of live larvae present in raw or undercooked marine fish. Clinical features include severe epigastric pain, frequently accompanied by severe allergic reactions. We investigated the prevalence of immunoglobulin E (IgE) specific for 5 Anisakis allergens in Italian patients sensitized or allergic to the parasite. The results were compared with those obtained previously in a similar Spanish population.
  
  
  METHODS
  We conducted a descriptive, cross-sectional validation study. Asymptomatic Anisakis-sensitized subjects (15 Italian and 17 Spanish) and Anisakis allergic-patients (42 Italian and 35 Spanish) were studied by ImmunoCAP, Western-blotting with nAni s 4 and dot-blotting with rAni s 1, rAni s 5, rAni s 9 and rAni s 10.
  
  
  RESULTS
  Anisakis IgE CAP classes 1 or 2 were associated with a high probability of asymptomatic sensitization (66.7%) while CAP classes 4 or above, were associated with a very high probability of allergy to Anisakis (95.2%). The most frequently detected allergen among Italian and Spanish allergic patients was Ani s 1. All of the Spanish patients versus 76.2% of the Italian patients recognized at least one of the allergens tested. Patients suffering from gastrointestinal symptoms only were significantly more frequent among the Italians whereas the Spanish presented more frequently with urticaria, angioedema or anaphylaxis.
  
  
  CONCLUSIONS
  Anisakis hypersensitivity shows different immunological patterns in different European countries. Allergen component diagnosis might help us to better understand this complex entity. Anisakis-specific IgE levels may have moderate prognostic significance.
authors.affiliation: Department of Immunology, Hospital Carlos III, Madrid, Spain.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Caballero
authors.forename: Riccardo
authors.initials: R
authors.lastname: Asero
authors.forename: Leonardo
authors.initials: L
authors.lastname: Antonicelli
authors.forename: Erilda
authors.initials: E
authors.lastname: Kamberi
authors.forename: Caterina
authors.initials: C
authors.lastname: Colangelo
authors.forename: Paolo
authors.initials: P
authors.lastname: Fazii
authors.forename: Carmen
authors.initials: C
authors.lastname: de Burgos
authors.forename: Rosa
authors.initials: R
authors.lastname: Rodriguez-Perez
mesh_terms: D000485:Allergens / Q000276:immunology*; D000818:Animals; D017163:Anisakis / Q000276:immunology*; D000947:Antigens, Helminth / Q000276:immunology; D015153:Blotting, Western; D002135:Calcium-Binding Proteins / Q000276:immunology; D003430:Cross-Sectional Studies; D005512:Food Hypersensitivity / Q000276:immunology; D015801:Helminth Proteins / Q000276:immunology; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology; D015151:Immunoblotting; D007073:Immunoglobulin E / Q000276:immunology; D007558:Italy; D013030:Spain
chemical_list: D000485:Allergens; D000947:Antigens, Helminth; D002135:Calcium-Binding Proteins; D015801:Helminth Proteins; C412511:troponin-like protein, Anisakis simplex; D007073:Immunoglobulin E